Trusted Information for Healthy Pregnancies
obesity
Excess weight raises pregnancy risks: study
Feb 12th
Being overweight or obese increases a woman's chances of having an extra-big baby, even after the effects of pregnancy-related, or "gestational," diabetes are taken into account, new research shows.
Excess weight in and of itself also sharply increased a woman's risk of pre-eclampsia, a potentially deadly pregnancy complication, Dr. Boyd E. Metzger of Northwestern University Feinberg School of Medicine in Chicago and his colleagues found.
Women have more difficulty delivering very large babies, while these newborns are also at risk of suffering injury during birth, including shoulder dislocation. While women who are overweight or obese are known to run a greater risk of having very large babies and experiencing other pregnancy complications, it has been difficult to separate out the effects of a mother's weight from those of gestational diabetes, Metzger and his colleagues note in the British Journal of Obstetrics and Gynecology.
This led them to investigate whether body mass index (BMI) -- a standard measure of weight in relation to height used to gauge how fat or thin a person is -- might influence pregnancy risks and fetal and newborn health, independently of a woman's blood sugar levels.
The study involved 23,316 women from 15 different medical centers in nine different countries. All had undergone an oral glucose tolerance test, which is used to identify women with, or at risk for, pregnancy-related diabetes; at that time, their height and weight were measured, too.
The researchers then used statistical techniques to control for women's oral glucose tolerance test results. Even after this adjustment, they found that the women with BMIs of 42 or greater, denoting severe obesity (for example, a 5-foot-5-inch tall woman weighing at least 250 pounds), were at more than triple the risk of having an excessively large baby, compared to the thinnest women in the study, who had BMIs of 22.6 or less (a 5'5" woman weighing less than 138 pounds).
The heaviest women's risks of having a C-section were more than doubled, while their likelihood of pre-eclampsia was 14-fold greater than for the leanest women. However, the heaviest women's risk for delivering a preterm baby was actually cut in half.
These findings help sort out the role BMI and gestational diabetes each play in the risk of complications of pregnancy and delivery, Metzger told Reuters Health in an interview.
He noted that recent studies have shown that dietary changes can effectively treat gestational diabetes for more than 90 percent of women with the condition.
"We're pretty confident that treating gestational diabetes going forward is going to continue to be beneficial," the researcher said. "We have much less evidence at this point as to how to neutralize or reduce the impact of overweight on pregnancy outcome."
What is becoming clear, he added, is that it's probably a woman's weight before she gets pregnant, rather than how much she gains during pregnancy, that's important in determining risk.
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ADHD linked to obesity during pregnancy
Jan 6th
Children are at double the risk of displaying symptoms of attention deficit hyperactivity disorder if their mother was overweight or obese when she became pregnant, according to European research.
It confirms for the first time in a large-scale study a suspected link between mothers' weight and children's mental health.
The study of nearly 2000 Swedish children identified a reduced ability to pay attention at school or preschool among those whose mothers had been overweight. This was even after taking into account the possible effects of mothers' mental health - which could influence the children's upbringing - and the children's own weight.
Children of obese mothers were also twice as likely to express negative emotions such as sadness and fear, and to have difficulty dealing with these appropriately, according to the research by Alina Rodriguez, a psychologist from the University of Uppsala. Her study followed the health of children from the first weeks of their mother's pregnancy through to age five.
Dr Rodriguez said a possible explanation was that excess weight might disrupt mothers' metabolism, making it harder for nutrients essential to brain development to reach the foetus.
Pregnancy puts huge stress on the metabolism, she said, and excessive weight gain might throw it out of balance - perhaps by raising mothers' levels of blood glucose, or of the hormone leptin.
Alternatively, the findings might result from inadequate vitamin D - which is linked to mental development and is known to be present in lower levels in overweight women - or from greater exposure to damaging chemicals, which accumulate in body fat.
Dr Rodriguez said her results, published in the Journal of Child Psychology and Psychiatry, could not prove whether maternal obesity caused the problems.
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Folic Acid May Help Prevent Fetal Heart Defects
Dec 9th
Here's another reason for pregnant women to take folic acid supplements: they help prevent fetal heart malformations, new research from the Netherlands suggests.
"Given the relatively high prevalence of congenital heart defects worldwide, our findings are important for public health," Dr. Ingrid M. van Beynum of Radboud University in Nijmegen and her colleagues write.
Folic acid supplements are now recommended for all pregnant women, and women planning on becoming pregnant, in order to prevent birth defects involving the neural tube such as spina bifida. Many countries, including the US, now require bread and other wheat products to be fortified with folic acid for this reason, but this practice hasn't been adopted in The Netherlands.
To investigate further, the researchers used a national register of birth defects to identify 611 mothers who had given birth to a child with a heart defect, matching them to 2,401 women who delivered babies with genetic defects or other birth defects unrelated to folate.
Women who took a supplement containing at least 400 micrograms of folic acid were nearly 20 percent less likely to have a child with a heart defect, compared to other non-folate-related malformations, while their risk compared to the general population was 26 percent lower.
Their risk of having a child with a heart defect involving the septum -- which separates one side of the heart from the other -- was nearly 40 percent lower than that of the general population.
The current study couldn't show whether taking more or less than 400 micrograms of folic acid would be more effective in preventing heart defects, the researchers note, although there's increasing evidence that heavier women may need to take more folic acid to get the same protective effects.
The researchers conclude that women who want to become pregnant should take folic acid supplements around the time of conception, not only to prevent neural tube defects but also to reduce the risk of congenital heart defects.
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Glucose Intolerance in Pregnancy Associated With Postpartum Cardiovascular Risk
Dec 6th
Women who have gestational glucose intolerance (a condition less severe than gestational diabetes) exhibit multiple cardiovascular risk factors as early as three months after birth, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Breastfeeding Could Offer Protection Against Metabolic Disorder
Dec 3rd
Breastfeeding may offer mothers long term protection against a condition linked to diabetes and heart disease, researchers report today.
The longer women breastfed, the lower their chance of developing metabolic syndrome, a cluster of risk factors such as high blood pressure and high triglycerides associated with obesity, the scientists found.
"Pregnancy may have some adverse effects on some of these cardiovascular risk factors," lead author Erica Gunderson says, "and lactation (breastfeeding) may offset some of these effects."
The impact of breast-feeding on the risk of metabolic syndrome was "slightly stronger" in women who'd had gestational — or pregnancy-induced — diabetes, says Gunderson, an epidemiologist and research scientist at Kaiser Permanente's Division of Research in Oakland. "This is the first study to really look at lactation and the metabolic syndrome in women with GDM (gestational diabetes)."
About 18%-37% of U.S. women ages 20 to 59 have metabolic syndrome, Gunderson says. A study she published in August found women with gestational diabetes are 2½ times more likely than other women to develop the condition after pregnancy.
Gunderson and her co-authors based their new findings on 704 women in an ongoing, government-funded study of heart-disease risk factors. When the women entered the study in 1985-1986, they were ages 18-30 and had never given birth; testing confirmed they didn't have metabolic syndrome.
They all went on to deliver at least one child; only 16% had more than two children. They returned for measurements of metabolic syndrome components seven, 10, 15 and 20 years after entering the study; 120 developed metabolic syndrome.
In women who didn't have gestational diabetes, breast-feeding cut metabolic syndrome risk 39%-56%. In those who did, it cut the risk 44%-86%. In both, the authors write in Diabetes: The Journal of the American Diabetes Association, the longer women breast-fed, the lower their risk.
Breast-feeding is associated with a quicker loss of pregnancy weight, but that's only "a little bit of the explanation," Gunderson says. Another possibility, she says: Breast-feeding might minimize the accumulation of belly fat, fat linked to type 2 diabetes risk.
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Sugary Soda Tied to Gestational Diabetes
Dec 2nd
Women who drink five or more servings of sugar-sweetened cola per week before they conceive increase their risk of developing diabetes during pregnancy, a new study indicates.
"Previous studies have shown an association with other chronic metabolic problems," said study author Dr. Liwei Chen, an assistant professor of epidemiology at Louisiana State University Health Sciences Center, in New Orleans. "This is the first to show an increased risk among pregnant women."
Gestational diabetes, known as glucose intolerance during pregnancy, is one of the most common complications of pregnancy. It increases the chances of lifelong diabetes for the woman and also can have permanent effects on the unborn child, Chen said. The report appears in the December issue of Diabetes Care.
"Other studies suggest that babies born to women who are diabetic during pregnancy have higher weight at birth and also higher rates of obesity and diabetes early in life," she added.
Chen, working with researchers at the Harvard School of Public Health and the U.S. National Institute of Child Health and Human Development, studied 10 years of medical records on a group of 13,475 women from the Nurses' Health Study II. After adjusting for known risk factors for gestational diabetes, such as age, family history and smoking, the researchers found that women who had more than five servings per week of sugar-sweetened cola beverages had a 22 percent higher risk of gestational diabetes than women who had less than one serving per month.
No such association was found for consumption of other sugar-sweetened beverages or artificially sweetened drinks.
It's not clear why only cola drinks are associated with the increased risk, Chen said. One explanation could be "the tremendous popularity of cola in the United States," she said.
According to the journal report, there are several potential explanations for the association. For example, sugar-rich foods or beverages can overload the body with glucose, which can impair the function of the beta cells of the pancreas, which make insulin that metabolizes glucose.
Sugar-sweetened beverages are the leading source of added sugar in the American diet, Chen said. The U.S. National Health and Nutrition Examination Survey found that soft drink intake more than doubled between 1977 and 2001 among 19- to 39-year-old Americans, going from 4.1 percent to 9.8 percent, and that those in this age group had the highest rate of soft drink consumption.
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Exercise Until End of Pregnancy Deemed Beneficial
Nov 12th
"Partaking in low-level physical activity has beneficial effects on materno-fetal health." These findings have recently been published in the International Journal of Obesity and highlight the benefits for the health of the baby and the mother when a physically-active lifestyle is maintained throughout pregnancy.
"An exercise regime carried out during the second and third trimester of pregnancy does not harm the health of the fetus," said Jonatan R. Ruiz, researcher at the Karolinska Institute, Sweden, and principal author of this study, who has coordinated a team from the Polytechnic University of Madrid in collaboration with the Swedish centre.
160 healthy women between the ages of 25 and 35 took part in the study, all of whom had sedentary habits and no risk of premature birth. Of this group of women, half followed an exercise regime under the supervision of experts in Physical Activity and Sports Science in collaboration with the Gynaecology and Obstetrics Unit of Hospital Severo Ochoa in Madrid.
The researchers used multiple variables to assess the health of the fetus (body weight, size and gestational age) in women, and they analyzed the effect of the training program carried out during the second and third trimester of pregnancy on the weight and size of the fetus.
"Body size and gestational age, as well as other health parameters, were similar in the group of women who followed the exercise regime compared to those who did no form of physical activity during pregnancy, which indicates that exercise poses no threat to the health of the fetus," Ruiz emphasizes.
The authors also measured the pre-pregnancy body weight of the mother, the body size of the fetus, and whether diabetes was developed during gestation. In the group of women who did not partake in any exercise (control group), it was observed that the mother's weight before becoming pregnant was positively associated with the weight of the newborn.
"Sedentary mothers of higher pre-gestational weight gave birth to heavier newborns. This relationship, however, was not observed in the group of women who exercised during pregnancy," the researcher concludes. According to experts, babies with excessive weight (more than 4 kg) are more at risk of developing diabetes and certain types of cancer as adults, in addition to complications that may occur at birth.
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